2
Chapter 2
ARTHROSCOPY & LAPAROSCOPY
Arthroscopic stifle surgery in
dogs
Meniscal resection is without doubt one of the most challenging
arthroscopic procedures but with practice can be accomplished in a
matter of minutes. These may be the common “bucket handle” tears,
complex horizontal cleavage tears or “parrot beak” tears. We routinely
perform meniscal resection with a combination of hook knives (Dr Fritz),
fine angled punches
(Slender Punch, Arthrex)
and shavers (2mm to
3.5mm Dissector, Arthrex).
Indeed some studies have
shown that this may be all
that is required in some
patients with CCL tears
and concurrent medial
meniscal injury (12) and in
selected patients this has
become our approach to
management in
combination with
rehabilitation (unpublished
work).
Arthroscopic Distractor (AR-17-01)
Pat Ridge BVSc Cert VR Cert SAS MRCVS,
Ridge Referrals, South Devon.
The first report of stifle arthroscopy in dogs was back in 1978 (1) and in
the UK in 1981 (2). Since then stifle arthroscopy has struggled to be
accepted or practiced widely in the UK although in the USA it is more
commonly employed in private referral and academic practice. Without
doubt the learning curve is steep and the equipment needed
considerable but the benefits in accuracy of joint examination and
reduced morbidity have been demonstrated (3, 4).
Positioning is critical to success and we use a moulding vacuum table
bag (Olympic Vac Pac) and a custom stifle brace (Veterinary
Instrumentation) with the patient in dorsal recumbency and the table
tilted 30 degrees from horizontal. Portals are created medial and lateral
to the straight patella tendon with an egress cannula placed in the
medial suprapatella pouch (5). A complete examination of the
femoropatella and then femorotibial joint can then be performed and this
can include examination of the caudal femorotibial joint where
necessary. Arthroscope size varies according to patient size but we
usually use a 2.4mm ‘scope although we regularly perform joint
examinations in patients as small as cats (6) using a 1.9mm ‘scope and
for patients in excess of 60kg we use a 4mm ‘scope.
The fat pad in dogs is considerably larger than that in humans and in
order to create a viewing window a motorized shaver (Adapteur Power
System, Arthrex) should be used to remove the inflamed fat pad,
synovium and torn fibres of cranial cruciate ligament (CCL). The majority
of dogs will require a 3mm aggressive style shaver blade (Dissector
Range, Arthrex) and this is attached to suction so that the debrided
tissue is removed from the viewing area. In order that the joint is
distended a fluid ingress system is required and we use a fluid pump
that automatically maintains the pressure as suction is used (Continuous
Wave II Pump, Arthrex), which is available on free loan with an annual
purchase commitment.
Before Distraction
After Distraction
For those who are interested both the ESVOT Arthroscopy Working
Group and the Arthrex VA3 group have regular meetings providing an
invaluable forum for discussion and practical experience in small animal
arthroscopy.
Meniscal injury occurs in around 40% of dogs with CCL damage (7, 8)
and isolated medial (9) and lateral (10) meniscal injury have also been
reported in the dog. Examination of both menisci can be extremely
challenging via an arthrotomy whilst the CCL is intact and recently Hulse
and others (11) have suggested that the remaining functional CCL in
partial tears may be “saved” by performing a tibial plateau leveling
osteotomy. During arthroscopy both menisci may be completely
examined, including careful palpation of the caudal horn, with the CCL
intact. This is made easier with the use of a stifle distractor (Veterinary
Instrumentation) applied via insertion of 2mm Ellis pins into the medial
femoral condyle and proximal tibia. The use of this particular instrument
does not “crowd” the joint space with instruments so reduces the risk for
articular cartilage damage and leaves plenty of space for instruments to
be inserted to palpate structures or remove torn portions of meniscus,
whilst at the same time allowing stifle flexion and extension.
1.
Seimering, G. H. (1978) Arthroscopy of dogs. Journal of American Veterinary
Medical Association March, 575- 577
2.
Kivumbi, C. W. and Bennett, D. (1981) Arthroscopy of the canine stifle joint.
The Veterinary Record 109, 241- 249
3.
Hoelzler, M. G., Millis, D. L., Francis, D. A. and Weigel, J. P. (2004) Results of
arthroscopic versus open arthrotomy for surgical management of cranial
cruciate ligament deficiency in dogs. Veterinary Surgery 33, 146- 153
4.
Pozzi, A., Hildreth, B. E. And Rajala- Schult, P. J. (2008) Comparison of
arthroscopy and arthrotomy for diagnosis of medial meniscal pathology: an ex
vivo study. Veterinary Surgery 37, 749- 755
5.
Beale, B., Hulse, D., Schulz, K. and Whitney, W. (2003) Arthroscopically
assisted surgery of the stifle joint. In: Small Animal Arthroscopy, Saunders,
Philadelphia. Pp 117- 158
6.
Ridge, P. A. (2010) Femoral condyle lesions similar to osteochondritis
dissecans: Call for opinions or similar cases. Letters to the Editor: Veterinary
and Comparative Orthopaedics and Tramatology 23, 377- 378
7.
Ralphs, S. C. and Whitney, W. O. (2002) Arthroscopic evaluation of menisci in
dogs with cranial cruciate ligament injuries: 100 cases (1999- 2000). Journal of
American Veterinary Medical Association 11, 1601-1604
8.
Hays, G. M., Langley Hobbs, S. J. and Jeffery, N. D. (2010) Risk factors for
medial meniscal injury in association with cranial cruciate ligament rupture.
Journal of Small Animal Practice 51, 630- 634
9.
Ridge P. A. (2006) Isolated medial meniscal tear in a Border Collie. Veterinary
and Comparative Orthopaedics and Traumatology 19, 110- 112
10. Williams, R. A. (2010) Isolated lateral meniscus tear in a Boxer. Veterinary
Record 11, 419- 420
11. Hulse, D., Beale, B. And Kerwin, S. (2010) Second look arthroscopic findings
after tibial pleateaux levelling osteotomy. Veterinary Surgery 39, 350- 354
12. Tivers, M. S., Comerford E. J. and Owen, M. R. (2009) Does a fabella-tibial
suture alter the outcome for dogs with cranial cruciate ligament insufficiency
undergoing arthrotomy and caudal pole medial meniscectomy? Veterinary and
Comparative Orthopaedics and Tramatology 4, 283- 288
Meniscal Tear
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ARTHROSCOPY & LAPAROSCOPY
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Arthroscopes
Arthrex Arthroscopes
An arthroscope is a rigid endoscope consisting of a system of lenses,
which collects and transmits an image from the tip of the instrument along
the shaft to an eyepiece or camera. A light post close to the eyepiece
allows light to be passed into the shaft and down optic fibres surrounding
the lens system to illuminate the subject area at the tip.
Arthrex are leaders in the field of arthroscopy with a deserved reputation
for innovation and quality. We are pleased to offer their top of the range
arthroscopes and sheaths at a very competitive price. 2.7, 2.4 and 1.9
arthroscopes are offered here but 4.0 are also available.
Please e-mail or call our Vet Tech team for a quotation.
+44 114 2588530
[email protected]
The diameter refers to the outside diameter of the unsheathed shaft of the
telescope. Three sizes are commonly used in small animal arthoscopy:
2.7mm, 2.4mm and 1.9mm. Arthroscope technology has improved so
much that optically the new 2.4mm arthroscope is as good as the older
2.7mm version. The 2.4mm arthroscope is fine for most procedures but
can prove a little large in small elbows. As the diameter of the arthroscope
becomes smaller, there is less space for optical fibres, which has
implications for light transmission and image size. Recent improvements in
construction such as the use of rod lens systems as opposed to optic
fibres has improved the performance of the smaller arthroscopes.
Additionally the smaller arthroscopes are fragile and care must therefore
be exercised to avoid damage in use, cleaning and storage.
2.4 Arthroscope x 10cm, 30˚
2.4 Sheath with Single Stopcock 3.2mm x 85cm
The viewing angle is the angle between the lens face and a line drawn at
right angles to the long axis of the arthroscope (see above right).
A 0˚ scope views straight ahead from the front of the lens, while a 90˚
scope sees an image at right angles to the long axis of the scope. Most
veterinary arthroscopes have a viewing angle of 30˚, which is a
compromise between field of view and distortion. The user needs to be
aware which way the lens is pointing. The light post is used as a reference
point and is positioned opposite the angle of view. Rotating the scope
along its long axis will allow the surgeon to view a large area within the
joint with minimal repositioning. An oblique viewing angle does offer the
surgeon a limited ability to see ‘around corners’.
Obturator, Blunt
Each arthroscope will require a dedicated sheath, which protects the
arthroscope as well as delivering fluid to the tip. The sheath reduces the
effective working length and increases the working diameter of the
arthroscope.
ARTHREX ARTHROSCOPES AND SHEATHES
Schematic of the tip of
a typical arthroscope
IR-1030
2.7 Arthroscope x 18.0cm, 30 ˚
£1,475.00
IR-1070
2.7 Arthroscope x 18.0cm, 70˚
£1,475.00
IR-1100
Arthroscopy Sheath 4mm x 12.5cm, with Telescope
Snap-in Locking mechanism, 2 stopcocks
£375.00
IR-1101
Arthroscopy Sheath 4mm x 12.5cm, with Telescope
Snap-in Locking mechanism, 1 stopcock
£375.00
IR-1200
Obturator Semi Sharp
IR-2030
2.7 Arthroscope x 11.0cm, 30˚
IR-2100
£70.00
£1,250.00
Arthroscopy Sheath 4mm x 7.5cm, with Telescope
Snap-in Locking mechanism, 2 stopcocks
All arthroscopes are now available in autoclavable versions. Autoclaving,
especially of fine arthroscopes, will significantly reduce the working life of
the instrument. Autoclavable arthroscopes may be soaked and we
recommend this method of sterilisation to preserve your arthroscope. If
your arthroscope is not marked autoclavable, it may only be soaked.
£375.00
IR-3030
2.4 Arthroscope x 10.0cm, 30˚
IR-3100
2.4 Sheath 3.2mm dia x 8.5cm working length.
1 Stopcock
£395.00
IR-3102
2.4 Sheath 3.5mm dia x 6.5cm working length.
2 Stopcock Rotating Option
£395.00
IR-3201
2.4 Obturator Blunt
IR-4030
1.9 Arthroscope
IR-4100
1.9 Sheath
IR-4200
1.9 Obturator Blunt
£75.00
IR-4201
1.9 Obturator Sharp
£75.00
£1,275.00
£80.00
£1,250.00
BXS2506050 Arthroscope Sterilisation/storage box 250x60x50mm
£395.00
£80.00
Arthroscopy Repairs
Most damaged or broken arthroscopes can be repaired. Although never
cheap the repair is normally a full refurbishment to new standard and
may be considerably cheaper than a new arthroscope. The same
applies to hand instruments which by their nature are delicate and
vulnerable. Send your repair to our Vet Tech team for a quotation.
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ARTHROSCOPY & LAPAROSCOPY
Arthroscopic Instrumentation
Arthroscopy Starter Kit
Instrument choice is determined by personal choice and patient
selection. However a starter kit is a useful starting point and offers a
discounted approach to setting up.
Irrigation and Working Cannulae,
Trochar Changing System designed by VAN BREE
The Arthroscopy kit described is discounted by 10% compared to buying
the individual components.
Cannulae and portals: In order to fully examine the joint under
investigation it may be necessary to manipulate some intra-articular
structures. The instruments used must be small and be introduced either
directly through the peri-articular soft tissues or via a dedicated cannula.
Where serial insertions and withdrawals or a range of instruments are
required, particularly through multiple layers of soft tissue, a cannula is
preferable to minimize trauma, (trying to re-find a portal can be
frustrating). Sets of cannulae dedicated to the most common joints are
now available. Initially a small diameter cannula is inserted using a
trochar, the portal may then be enlarged by the use of a ‘switching stick’.
The stick is inserted into the joint through the small cannula which is
then withdrawn. Larger cannulae may be slid down the changing stick
and introduced into the joint. Exchanging a small cannula for a larger
one can be surprisingly difficult without such an aid. The system is
colour coded for ease of use.
In addition to arthroscopic hand instrumentation a suitable camera and
light source will be required. Several options, including pre-owned units,
are available. Please telephone or e-mail to discuss options.
Code
Description
Cannula Sets
I-17-755
Working Cannula Set "shoulder and elbow" designed by
VAN BREE, D:2.3 / 2.9 / 3.5mm; WL:3.5-5cm and 7-8 cm,
includes sharp trochar and changing rod
£550.00
I-17-500
Working Cannula Set "elbow" designed by VAN BREE,
consist of 3 cannulas D:2.3 / 2.9 / 3.5mm; WL:3.5-5cm.
includes 1 sharp trochar and 1 changing rod (2.3mm) £350.00
I-17-700
Working Cannula Set "shoulder" designed by VAN BREE,
consist of 2 cannulas D:2.9 / 3.5mm, WL:7-8cm.
includes 1 sharp trochar and 1 changing rod (2.8mm) £230.00
I-18-518
Egress cannula, with sharp trochar stopcock,
ID:3mm, WL:7mm
IR-3030
2.4 Arthroscope x 10.0cm, 30˚
IR-3100
2.4 Sheath 3.2mm dia x 8.5cm working length.
1 Stopcock
I-18-518
Egress cannula, sharp trocar, stopcock
IØ 3mm, WL 7cm
I-17-755
Working cannula set "shoulder & elbow"
Designed by van Bree, D:2.3/2.9/3.5mm;WL:3.5-5cm
S140-2438F
Target instrument designed Dr.Lehmann
for canine arthroscopy; comp.with S110-1932
AR-17-09S
Hook probe, 2.2mm, silicon handle
comp. autoclavable, colour code:red
AR-17-06S
Currette, small 2.7mm, silicon handle
yellow, autoclavable, colour code:red
AR-17-07S
Ring currette, 2.7mm, silicon handle
red, autoclavable, colour code:black
AR-17-19S
Hook knife, 2.7mm, Silicon handle
orange, autoclavable, colour code:blue
AR-17-11S
Smilie knife, 2.7mm, silicon handle
yellow, autoclavable, colour code:red
AR-17-05S
Banana knife, 2.7mm, with silicone handle
autoclavable, colour code:green
AR-17-03S
Bayonett knife 2.7mm, silicon handle
yellow, autoclavable, colour code:black
AR-17-12S
Micro picking knife, designed by Brian Beale
2.7mm, silicon handle, yellow
AR-17-13
Special elevator, 2.7mm, with handle
colour code:metal
I-17-822
Milling drill for arthroscopy
AS-17-561
Mini grasping forceps D:2.0mm WL:11cm, high quality,
AS-17-662
Alligator grasping forceps
with ratchet OD:2.7mm; WL:12cm, high
AS-17-762
Universal rongeur and grasping forceps
OD: 3.4mm, WL: 12cm without ratchet
AS-17-531
Mini rongeur and biopsy forceps
OD: 2mm, WL: 11cm
AS-17-632
Universal rongeur and grasping forceps
fenestrated, OD:2.7mm; WL:12cm
AR-08-100
Pressure infusion cuff for 500-1000ml
complete with manometer and hand pump
DE-5-17
Cleaning brush, small, 17cm
DE-10-425
Soak basin for chemical solution disinfection
DE-10-25
Camera covers disposable, (30)
£150.00
Thanks to Noel Fitzpatrick for the photograph
For further information about the Arthroscopic Stifle
Lever see Page 41
ARTHROSCOPY STARTER KIT
ARTHROKIT
58
Arthroscopy starter kit
£7,450.00
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ARTHROSCOPY & LAPAROSCOPY
www.vetinst.com
Hand Instruments
Arthroscopy Hand Instrument Set
A useful set of three arthroscopy instruments for
examination and intra-articular surgery. The two hand held
knives can deal with most meniscal tears, whilst the black
shaft of the hook probe minimises reflection.
Hand instruments for investigation are designed to move or retract
intra-articular structures and usually take the form of blunt probes or
grasping forceps. Where intra-articular surgery or sampling is involved
additional cutting instruments will be required.
AR-17-09S
Hook probe 2.2mm, with silicon handle
£175.00
AR-17-13
Elevator, heavy, 2.7mm, with metal handle
£175.00
ARTHROSCOPY HAND INSTRUMENT SET
AR-17-03S
AR-17-05S
Bayonet knife 2.7mm, with silicon handle
Banana knife 2.7mm, with silicon handle
£175.00
AR-17-19X
Pull Knife
£75.00
AR-17-11X
Push Knife
£75.00
AR-17-10
Hook Probe 2.2mm, with stainless handle, black shaft
£62.50
AR-17-SET
Arthroscopy Hand Instrument Set
£175.00
£175.00
Gordon Coronoid Osteotome
AR-17-06S
AR-17-07S
Curette 2.7mm, curved, with silicon handle
Ring curette 2.7mm, small, with silicon handle
£175.00
Designed and developed by Ian Holsworth, this narrow osteotome is used
for arthroscopic sub-total coronoidectomies.
£175.00
GORDON CORONOID OSTEOTOME
Hold tear with clamp and push knife
against ‘handle’ to detach from body
of meniscus.
AR-17-11S
Meniscus knife, Smillie, 2.7mm, with silicon handle
£175.00
Use to pick area to encourage
regeneration.
AR-17-12S
Micro picking knife, acc to Dr Brian Beale 2.7mm,
with silicon handle
AR-17-30
Gordon Coronoid Osteotome (4mm)
£57.50
AR-17-29
Gordon Coronoid Osteotome (2mm)
£57.50
Suture Passing Wire
£175.00
Use to hook under meniscal tears and
detach handle from body of meniscus.
AR-17-19S
Hook knife 2.7mm, with silicon handle
£175.00
Passing soft suture material through bone tunnels of soft tissues without
causing additional trauma can be a challenge to the surgeon. The Arthrex
Suture Passing Wire consists of a Nitinol loop attached to a flexible yet stiff
wire. The wire may be pushed through bone tunnels of soft tissues and as
the tip emerges the Nitinol loop naturally springs open to receive the suture
which may then be pulled back through.
Inserts for interchangeable hand instrument (AR-17-00) are available.
Please call for details.
SUTURE PASSING WIRE
AR-1255-18
001049a
Arthroscopic Hohman 4mm
Suture Passing Wire 600mm
£70.00
Crystal Cannula
£55.00
Clear cannula
has a lip at the
tip to minimise
‘fall out’.
Milling Drill designed by VAN RYSSEN & VAN BREE
This hand driven bur allows curretage of both cartilage and bone through
the smallest working cannula. Much cheaper and easier than shaver
systems.
I-17-822
Milling drill for arthroscopy complete
OD:2.2mm, WL:12cm
£350.00
CRYSTAL CANNULA
I-17-821
Replacement bur and shaft
£120.00
AR-6560
59
Crystal Cannula 5.75mm x 700mm (5 Pack)
£105.00
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ARTHROSCOPY & LAPAROSCOPY
Arthroscopic Punches,
Biopsy Forceps, Rongeurs and
Grasping Forceps
AS-17-621
Arthroscopic forceps and rongeurs should be selected according to patient
and portal size. A very small pair of grasping or cutting forceps will fit any
portal but will be easily damaged if used on large fragments. Various designs
are available for grasping cutting, or nibbling intra-articular structures.
Arthroscopic hook scissors,
OD:2.7mm
£650.00
3.4mm Instruments
2.0mm Instruments
AS-17-762
• made for veterinary use
• overstraining protected
Universal rongeur and grasping forceps,
fenestrated without ratchet, OD:3.4mm working
length 12cm with overstraining protection
£750.00
Arthrex Hand Instruments
2.0mm Instruments, working length 11cm
Useful Additions to the VAR-3000S Arthroscopy Set
Angled Slender Meniscus Punches
AS-17-561
Mini grasping forceps, OD:2.0mm
£550.00
AS-17-531
Mini rongeur and biopsy forceps, OD:2.0mm
£550.00
AS-17-551
Mini punch for arthroscopy, OD:2.0mm
£550.00
AS-17-521
Mini scissor for arthroscopy, OD:2.0mm
£550.00
In the human knee management of meniscal tears is by arthroscopy
punches. Most human arthroscopy punches are too large for the canine
stifle even with appropriate distraction. Our external stifle distractor
(AR-17-01, page 62) offers the best possible access. The Arthex slender
punches are small enough and the best available. The straight one is
included in VAR-3000S. If you can afford them the punches angled left and
right work best of all.
2.7mm Instruments
Slender Pointed Grasping Forceps
2.7mm Instruments, working length 12cm
AS-17-662
AS-17-632
Alligator grasping forceps with rachet, OD:2.7mm
with overstraining protection
£725.00
Pointed grasping forceps may be used for gentle dissection and grasping
of small intra-articular objects.
Universal rongeur and grasping forceps fenestrated
OD:2.7mm with overstraining protection
£650.00
Small Probe
AS-17-641
AS-17-672
Biopsy and spoon
OD:2.7mm with overstraining protection
Arthroscopic punch,
OD:2.7mm with overstraining protection
£650.00
ARTHREX ADDITIONAL HAND INSTRUMENTS
AR-11000
Slender Punch, Straight
£975.00
AR-11420
Slender Punch, Angled Left
£995.00
AR-11430
Slender Punch, Angled Right
VAR-11700NR Slender Pointed Graspers, Straight
£750.00
AR-30000
60
Small Probe
£995.00
£995.00
£195.00
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ARTHROSCOPY & LAPAROSCOPY
www.vetinst.com
Canine Arthroscopy Set (VAR-3000S)
Forceps Tray
VAR-11600SR Grasper, Alligator Hook Tip
VAR-11100 Punch, Slender Straight Tip
The forceps tray secures a Series I Grasper and Slender Punch in an
upright position for easy accessibility. The tray has space for two further
forceps.
Working with leading canine arthroscopic surgeons the Arthrex set
comprises a comprehensive range of instruments as three modules within
a custom autoclave case.
All the instruments are available separately but when bought as the boxed
set there is a saving of 10%.
Main Instrument Tray
VAR-3008 Small Cup Curette, 2.5 mm diameter
VAR-3009 Banana Knife, 2.5 mm diameter
AR-5021 Graduated Black Probe, 1.5 mm Tip
photo Mark Owen
AR-5007 Graduated Black Probe, 2.5 mm Tip
AR-10020 Probe, Stainless Steel
Grasper-Alligator,
Diameter 2.75mm with
Hooked Tip, Self Release
AR-3033 Obturator, Blunt
Canine Cannula Set (VAR-3002S)
Grasping and maintaining a grip on fragments can be very challenging for
both surgeon and instrument. Once locked on, the surgeon is
understandably reluctant to let go, sometimes taking an instrument beyond
its working limits.
The VAR-11600SR Alligator forcep is toothed for maximum grip and has a
self releasing handle.
The Alligator grasper is one of a range of canine arthroscopy instruments
available as a set from Arthrex Vet Systems through Veterinary
Instrumentation. Call or e-mail for a full brochure.
The Canine Arthroscopy Set combined with an Arthrex camera and light
source would comprise a start up set for arthroscopy of the canine stifle,
elbow, shoulder and hock.
VAR-3002 Cannulas (2.9, 3.7 & 4.3 mm)
VAR-3003 Cannulated Obturator
VAR-3004-2.9 Switching Stick, 2.9 mm
ARTHREX HAND INSTRUMENTS
VAR-3004-3.7 Switching Stick, 3.7 mm
VAR-3000S
Canine Arthroscopy Set Boxed
VAR-11100
Punch, Slender Tip
VAR-11600SR
VAR-3007 Stifle Outflow Obturator
Grasper-Alligator, Ø 2.75mm, with Hook Tip
VAR-3002S
Canine Cannula Set
The cannula set is available separately. The stand alone cannula set does
not include the Outflow Cannula and Obturator.
VAR-3006
Outflow Cannula with stopcock
£425.00
VAR-3007
Outflow Cannula Obturator
£210.00
VAR-3009
Banana Knife
£350.00
BRCANARTH
Canine Arthroscopy Literature
VAR-3005 Dilation Needles, qty. 5
VAR-3006 Stifle Outflow Cannula with stopcock
61
£4,945.00
£975.00
£975.00
£1,945.00
£FOC
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ARTHROSCOPY & LAPAROSCOPY
Shoulder Aiming Device
Light Sources & Cables
Developed and tested at the Veterinary Faculty
of Vienna, Austria by Dr Lehman.
Halogen light sources are inexpensive but not as good as the xenon based
systems, which are, unfortunately, significantly more expensive to purchase
and maintain. Xenon light sources have a higher intensity and are essential
if the unit is to be used for laparoscopic work. Thus Xenon is preferable but
halogen can be used successfully in most joint investigations. Both Xenon
and halogen bulbs have a limited life (Xenon typically 500 hours, halogen
typically 2000 hours) and bulb failure is at best embarrassing so always
carry a spare. The light cable carries light from the source to the
arthroscope by fibre optics. Each cable has dedicated connectors to couple
with the light source and the arthroscope. Connections on both light source
and arthroscope vary from manufacturer to manufacturer. Convertors are
available for both light source and arthroscope but it is wise, if possible, to
purchase the appropriate cable for the system.
Due to the dense muscle
mass in shoulder joints,
creating a puncture for a
working cannula is often
quite difficult. If a clean
puncture allowing access
directly to the joint is not
achieved the first time, the
risk of a subsynovial
oedema increases greatly.
H150-5-2 Halogen Light Source 150W
The shoulder puncture system has been specifically designed to help
eliminate this risk. The system allows you to align your arthroscope
accurately in the joint space. Simply attach the puncture system to the
arthroscopic sheaths and maintain your arthroscopic vision in a parallel
direction to the shoulder joint rim. At this point you will find the working
triangulation portal in an ideal position. After a puncture is created with the
desired trochar, simply replace the trochar with a working cannula and
start working with your instruments. Useful for both cranial and caudal
approaches. View at www.vetinst.com/videos
See VCOT 2004; 17:1-56 for review
S140-2438-F
Aiming device by Dr Lehman for the canine
shoulder for 2.4 scope T140-2432 and
changing rod I-17-028
£375.00
S140- 1938F
Aiming device by Dr Lehman for the canine
shoulder for 1.9 scope T110-1930 and
changing puncture rod I-17-028
£375.00
I-17-028
Changing & puncture rod
DVDLEHMAN
DVD on use of aiming device.
H150-5-130
Halogen light source 150W
£1,100.00
£90.00
Xenon Light Source
£FOC
Joint Distraction
Arthroscopic Joint Distractor
Osteoarthritic stifles can be very ‘tight’ making
examination and treatment of intra-articular lesions
difficult. Distraction of the articular surfaces using
intra-articular instruments is difficult and clutters
the operative field. Extra-articular distraction is
very effective and leaves potential instrument
portals available for more appropriate
instrumentation.
AR-17-01
Arthroscopic Distractor
LK-FX-100
Xenon light source
KW-48-231
Fibre light cable, 4.8mm, 2.3M,
both sides compatible to Wolf, autoclavable
£450.00
KS-48-231
Fibre light cable, 4.8mm, 2.3M, unit side comp.
to Storz, endoscope side comp.
to Wolf, autoclavable
£400.00
KS-48-230
Fibre light cable, 4.8mm, 2.3M, Olympus/Wolf
£425.00
KS-48-300
Fibre light cable, 4.8mm, 3.0M, Storz/Storz
£425.00
£3,450.00
£165.00
AR-17-01/TPLO Arthroscopic Distractor. 1/8” (3.2mm)pins
£165.00
Arthroscopic Stifle Lever
For further information including a detailed
product description see Page 41.
AR-17-02
Arthroscopic Stifle Lever
275mm
£115.00
All cable combinations available.
62
2
ARTHROSCOPY & LAPAROSCOPY
www.vetinst.com
Cameras & Monitors
Monitor
Direct viewing of the joint through the eyepiece is possible. However,
practicality and the issue of contamination dictate that a camera system is
an essential part of the equipment. Arthroscopic cameras work in a very
similar fashion to video cameras in common usage. The image at the
eyepiece of the arthroscope is focussed on a light responsive electronic
chip(s). The signal created is transferred to a camera controller, which
processes the image into a signal recognized by the monitor and/or
recording system.
Most veterinary cameras have a single chip, which is sufficient for most
users.
Flat Screeen Professional Monitor
The connection of the camera head to the eyepiece of the arthroscope is
also variable. To maximise the choice and longevity of the instrumentation
it is advised that a clip on camera head compatible with DIN standard
eyepieces be selected. The camera heads are fully immersible.
Pre-owned cathode ray tube type monitor
Professional monitors offer a better image than domestic screens as they
have a better resolution. Some pre-owned units are always available. Ring
for details.
Image Capture
Good practice dictates that a record is made of any arthroscopic
procedure. Subsequent investigations can be compared to earlier ones
and images can be shared and compared with colleagues or tutors as part
of a training programme. Domestic video recorders will create a permanent
record of a procedure. However the data is relatively crude and difficult to
manipulate. Still video printers capture an image from a video stream
which can then be printed onto photographic paper.
Arthrex Eagle Eye Cameras and Light Sources
Digital video and data storage technology now allows the surgeon to
record and store very large amounts of data in a digital format. The digital
information can subsequently be manipulated by appropriate computer
software to create both still and moving images in a variety of formats for
storage or display. If clinical presentations are anticipated then a digital
system is very desirable. Domestic DVD or combined DVD/Hard drive
recorders offer huge storage capacities at reasonable prices.
The data is stored as Digital Video (DV) which can be converted into many
other formats. The major arthroscopy companies offer sophisticated data
storage systems which are able to capture and store still and movie files
via sterile touch screens or camera finger controls. Permanent records are
maintained on DVD discs or computer hard drives.
Top quality equipment from a major human arthroscopic company but at
a discount price. It is important to obtain the best possible image.
Arthroscopy is difficult enough without working with poor quality images.
Buy the best ‘scope’ and camera you can afford. The Eagle Eye camera
is human quality as is the matching light source.
We usually have some pre-owned Sony video printers in stock.
Ring for details.
ARTHREX EAGLE EYE CAMAERAS AND LIGHTS
AR-5970SP
Eagle Eye Single Chip Camera
£4,375.00
AR-3595SP
Eagle Eye 300watt Xenon light Source
£4,095.00
AR-3041
Light Cable
EAGLE OFFER Eagle Eye Single Chip Camera
+ Xenon Light Source & Cable Save £3,495.00
USB Based Image Capture System
£525.00
£5,500.00
Camera Covers
DE-10-25
Camera covers, disposable, (30) polyethylene,
13 x 235cm (sterile)
£135.00
CAMPT
Camera cover with perforated tip
250cm x 12.5cm (60 sterile)
£135.00
Camera cover with elasticised tip
250cm x 12.5cm (60 sterile)
£160.00
CAMET
The latest version of the image capture device captures both still images
and mpegs directly onto a USB stick ready for transfer to permanent
storage.
Capture is activated by pressing a button on the front panel or if the
surgeon prefers to keep control there is an optional foot control.
DE-10-25/Single Single camera cover (disposable) 13 x 235cm (sterile) £5.75
DE-10-01
Camera cover, reusable, waterproof, washable,
autoclavable, 12 x 200cm, 1 pc
£75.00
63
46-USB-200
USB Image Capture Jpeg and Mpeg
£2,500.00
46-USB-15-1
Footswitch for USB Capture System
£150.00
2
ARTHROSCOPY & LAPAROSCOPY
Fluid Infusion and Outflow
Hand Pressure Infusion Cuffs
Infusion of fluids or gas into the joint is essential to create an environment
in which the arthroscope can view joint structures. The joint must be
expanded and debris removed to maintain a clear field of view.
To maintain an appropriate intra-articular pressure (between 40 and
100mm of mercury) (0.053 and 0.133 BAR) fluid inflow and outflow must
be carefully regulated. Fluid under pressure may be obtained by either
gravity feed systems or a pump. Gravity may be sufficient provided the
fluid bags can be lifted high enough but greater, more controllable
pressure may be obtained by use of a fluid compression bag.
The bag of fluid to be infused is placed into a pressure bag, which is
inflated using a hand or machine pump. Without careful monitoring hand
inflation systems offer erratic pressure levels and use of a regulated pump
offers much better control. A carbon dioxide powered pump may be used
to pressurize a compression bag or infuse carbon dioxide directly into the
joint. Dedicated roller type pumps are able to maintain a constant line
pressure over extended periods but they may require dedicated tubing, are
expensive to purchase and are more prone to breakdown.
To create fluid flow through the joint, appropriate fluid outflow or egress
must be maintained. In the smaller joints (elbow, hock and hip), a large
bore hypodermic needle may be sufficient. In the larger joints (shoulder,
stifle) where greater volumes of fluid are involved, dedicated multi
fenestrated egress cannulae may be necessary, the waste fluid may be
collected by either bag systems or suction devices.
Use of direct CO2 infusion is indicated in some inflamed joints where
inflammatory synovial villae obstruct the visual field, the villae being
flattened under gas pressure rather than floating free in infused fluid. In
addition, use of CO2 increases the field of view and image clarity of the
arthroscope. CO2 is usually used intermittently with fluid to allow for
flushing.
AR-08-100
Pressure infusion cuff for 500-1000ml complete with
pressure gauge and hand pump, reusable
AR-08-300
Pressure infusion cuff for 3000-5000ml complete with
pressure gauge and hand pump, reusable
£325.00
AR-08-110
Pressure infusion cuff for 500-1000ml without
pressure gauge, Luer Lock (fem), reusable
£175.00
AR-10-948
Silicon tube, 7x2mm, 3m, autoclavable,
Luer-Lock (m), needle (f), sterile bags/bottles
£125.00
X-7-20-10
Spare silicon tube, 1 metre, size: 7x2mm, colour: natural
£12.50
LLM-1258
Spare Luer-Lock connector, male,
comp. to silicon tubes 7x2mm
£15.00
AR-10-9
Spare needle for infusion bottles/bags, ID:5.5mm,
comp. to silicon tubes (7x2mm)
£45.00
X-180-26
Silicon tube, ID:5mm, 180cm, LLm both ends, autoclavable £40.00
X-5-15-10
Spare silicon tube, 1m, autoclavable,
size: 5x1,5mm, colour: nature
LLM-1250
Spare Luer-Lock connector (m), comp.
to silicon tubes (5x1.5mm)
£275.00
£9.50
£15.00
Pressure Pump Infusor
Features:
• automatic control
• pressure continously
adjustable
• max. 300mm Hg pressure
• easy handling
• no mechanical parts
• for fluid and CO2 supply
Peristaltic Infusion
Arthroscopy Infusion Pump
AR-10-100
Pneumatic pressure infusor, for infusion cuffs,
for veterinary arthroscopy, complete 4mm tube to
central pressure supply, DIN tube connection, front
side Luer-Lock (f), universal table fixator, easy pressure
setting, automatic regulation (0-300mmHg)
£1,250.00
Pressure Infusion Cuff
with fluid bag
Provided the surgeon is prepared to commit to the purchase of 100 patient
infusion sets per year Arthrex is prepared to offer its Continuous Wave
Arthroscopy Pump (AR-6450) (value £3,950) on free loan. This pump has
been in use in the human sector for some 15 years and is very reliable.
Line pressure and flow rate are user defined. This means that the fluid
pressure does not have to be continually monitored and adjusted by
nursing staff. In addition, if the tube pressure is correct, any problems with
fluid flow can be immediately localised to the arthroscope. This is not the
case with inflated cuffs where only the pressure within the bag is known.
Hand pump or Luer-Lock
(fem) for infusor
Connection
to fluid bag
Patient
Fluid
Supply
Infusor
Three
way
stopcock
Direct CO2 supply
(only in connection with CO2 infusor)
If you are performing 3 or more procedures per day it is cheaper to buy the
separate Machine (one per day) and Patient Tube Sets.
AR-10-901
CO2 Infusor, for large/small animal arthroscopy, DIN
connector tube to pressure reducer (DIN type) pressure
setting 0-300mm Hg tube connection Luer-Lock(f) £1,550.00
AR-6450
Arthroscopy Pump
AR-6415
Combination Machine and Patient Tube (10)
£295.00
Machine Tube Set (10)
AR-10-903
£325.00
Reduction valve for CO2-bottles, UK fitting
£165.00
AR-6410
AR-6325
Patient Only Tube Set (20)
AR-10-922
£180.00
Sterile filter system for CO2 infusor, disposable,
box with 50 pcs
£195.00
£3,950.00
64
2
ARTHROSCOPY & LAPAROSCOPY
www.vetinst.com
Shaver Systems
Electrocautery
Arthroscopic electrocautery or radiofrequency devices focally create heat
within the tissues to create haemostasis, debridement or to shrink the joint
capsule in selected cases of instability. Long, fine insulated probes are
available which may be powered by standard surgical electrocautery units.
The tips are bathed in fluid at all times but essentially the same processes
occur at the tissue level as in surgical electrosurgery.
Virtually the only powered instrument in use in veterinary arthroscopy is the
shaver. The shaver is essentially a motorized bur. It may be used to debride
cartilage, bone or soft tissues. A range of tips of different designs and sizes
are available to manage the different tissues. Tips designed for soft tissues
are typically larger and more aggressively toothed. Suction may be applied
to the cutting tip via the hand piece to remove debris. The hand piece is
driven by a control box operated by finger or foot controls. The speed and
direction of cut are selectable. The tips are usually designed to be
disposable, however with careful use, cleaning and re-sterilisation they may
be re-used. Very expensive to buy new, Veterinary Instrumentation
maintains a stock of high quality ex-hospital units for sale.
Radiofrequency devices create heat by inter-molecular friction. Tips are
available in both monopolar and bipolar formats and may be used to debride
structures such as damaged meniscus or fat pad. Capsular shrinkage by
radiofrequency may be used to tighten joint capsules following arthroscopy
or injury. Radiofrequency ablation dissolves intra-articular tissues at a
relatively low temperature. The resulting debris is removed by suction. The
technique is therefore an alternative to the shaver for removing soft tissues.
At least one manufacturer supplies combined shaver blades and ablator
wands which offer both options on the same intra-articular device.
Linvatec Shaver
The Linvatec Shaver
System is very interesting
from a veterinary
arthroscopy point of view
as it is able to use 2.0mm
micro burs. Other major
brands have a minumum
blade diameter of 2.8mm
which may not seem a
very big difference but is
almost half as big again.
Arthroscopic Procedure Electrosurgical System (OPES)
Includes the all important micro handpiece for the small burs.
LINSHAV
Linvatec Shaver System Complete
SBC9960
2mm Linvatec Micro Gator Shaver Blade
£120.00
SBC9950
2mm Linvatec Micro Cuda Shaver Blade
£135.00
SBC9911
2mm Linvatec Micro Spherical Shaver Blade
£130.00
SBC9961
2.9mm Linvatec Micro Gator Shaver Blade
£120.00
SBC9962
3.5mm Linvatec Micro Gator Shaver Blade
£120.00
SBC9264
3.5mm Linvatec Gator Shaver Blade
£120.00
SBC9253
3.5mm Linvatec Cuda Shaver Blade
£120.00
SBC9111
4.5mm Linvatec Spherical Shaver Blade
£130.00
£2,650.00
Ablation wands
Arthrex Shaver Offer
A comprehensive orthopaedic electrosurgical system combining
arthroscopic ablation, arthroscopic coagulation, open surgery monopolar
and bipolar surgery from one fully digital generator. With 3 in 1 system
flexibility, the OPES Electrical Generator is also capable of controlling a
host of different instruments, including disposable monopolar arthroscopic
electrodes, reusable and disposable monopolar open procedure pencils
and tips, and reuseable bipolar forceps. The need for separate and costly
systems is eliminated. Provided the surgeon is prepared to agree to an
annual purchase commitment Arthrex is prepared to offer its OPES
Console (AR-9600) (Value £6,250) on FREE loan. Email [email protected]
or phone John to discuss the purchase commitment.
Adapteur Power Systems
APS II Console
AR-8339FHandpiece
The Arthrex Adapteur II shaver is a current shaver with a value of over
£10,950. It takes a wide range of blades down to 2.0mm. Veterinary
Instrumentation can offer the Arthrex shaver on free loan provided that
the surgeon is prepared to purchase up front two boxes of blades (total
of 10 blades). The unit is supplied as standard with a foot controlled
handpiece. This unit is also available with hand control. Please specify
when ordering. Call for the Arthrex shaver blade brochure. Below are
described a useful selection.
ARTSHAV
Arthrex Shaver System Complete
AR-7285ST
Serrated tooth blade full radius,
2.85mm x 70mm (box of 5)
£495.00
AR-7300BT
Oval bur, small joint, 10 flute
3.0mm x 70mm (box of 5)
£345.00
AR-7300DS
Dissector small joint 3.0mm x 70mm (box of 5)
£345.00
AR-9600
OPES Console
AR-9600FB
Bipolar foot pedal
£250.00
AR-9611SFR
Bipolar forceps
£285.00
AR-961CR
Bipolar forceps cable
£130.00
AR-9610
Monopolar handpiece (disposable) (Box of 5)
£85.00
VAR-1005-01
Ground pad
£50.00
VAR-1005-06
Cable
£75.00
Ablation wands and electrodes from
£85.00
£10,950.00
BROPES
65
Opes Literature
£6,250.00
£FOC
2
ARTHROSCOPY & LAPAROSCOPY
Positioning Aids
Vac Pac Vacuum positioning device.
Manipulation of arthroscopes and instrumentation inside a joint via an
image on a monitor screen can be very demanding. Careful positioning of
the patient and the surgeon is essential.
An operating table, fully adjustable for height and tilt is a prerequisite for
good arthroscopy. Once fully draped, orientation around a canine limb can
be difficult. Full use should be made of channels, ties and sand bags to fix
the overall position of the dog. Sandbags may also be necessary to act as
a fulcrum to open a joint maximally for investigation, e.g. elbow.
To provide multiple fixed positioning during an investigation a multi arm
positioning device is available which when attached between the distal limb
and the table may be locked
into an infinite range of
positions. An optional
accessory allows the stifle to
be accurately positioned for
an investigation.
Thanks to Pat Ridge for the
photographs
020062
Simply mould the bead filled bag around or under the patient and hook up
to any vacuum source, as the air is removed the bag solidifies in the set
position. Especially useful for arthroscopy or any surgery requiring secure
accurate positioning. The Vac Pac is:
Re-useable
Radiolucent
Repairable
Warm
VAC-PAC
026000
020065
MULTIARM
Multi-arm positioning device
with single foot attachment
£245.00
020062
Double limb support for multi-arm
£135.00
020065
Stifle brace attachment for multi-arm
(designed by Schulz and Ian Holsworth)
£135.00
026000
VP23
Vac-Pac size 23
45 x 50cm
£295.00
VP30
Vac-Pac size 30
72 x 90cm
£425.00
VP31
Vac-Pac size 31
98 x 90cm
£425.00
VP32
Vac-Pac size 32
118 x 90cm
£425.00
Clear Adhesive Antibacterial Surgical Drapes
with Povidine
The majority of human
surgeries use clear
adhesive drapes over
the incision site.
Benefits include fluid
and pathogen
resistance, antibacterial,
transparent and
permeable. 4 sizes
available.
020065
CLEAR ADHESIVE SURGICAL DRAPES WITH POVIDINE
Table Top Stand for
Limb Suspension
Suspension of a limb can provide
significant benefits in both arthroscopy and
other orthopaedic procedures. The shoulder
joint is distracted and 360 degree access
becomes available. Height 1.2m (48”)
20 pieces/box
£34.50
20cm x 30cm
20 pieces/box
£44.50
AD3045
30cm x 45cm
20 pieces/box
£67.50
AD4560
45cm x 60cm
10 pieces/box
£67.50
ID6650
Ioban™ Drape 56 x 45cm Single
£28.50
Redmark Cradles
REDMARK CRADLES
TABLETOP STAND FOR SUSPENDING LIMB
Tabletop stand
14cm x 20cm
AD2030
Available individually or as a set of 3 these cradles are the best available.
For 2012 our limb suspension stand has
been re-designed to give greater table-top
stability. A cleat for tying off limb
suspension ropes has also been added and
the shaft can be dismantled for storage.
R463
AD1420
£135.00
026022
Redmark Cradles - set of 3 (S. M, L)
026022L
Redmark Cradle - Large over 32kg
£95.00
026022M
Redmark Cradle - Medium over 13kg - 32kg
£90.00
026022S
Redmark Cradle - Small up to 13kg
£85.00
See Chapter 18 for Drapes and Draping.
66
£210.00
2
ARTHROSCOPY & LAPAROSCOPY
www.vetinst.com
Fluid Management
Sterility
Sterile Incise drape with fluid collection pouch.
Arthroscopes
Distilled water and an enzymatic cleaner are used to remove gross
contamination from arthroscopes, sheaths and trochars. Arthroscopes are
available which can be autoclaved. However, repeated autoclaving of even
these arthroscopes will significantly reduce their working life. Sterility is
more commonly achieved by soaking in an anti-microbial solution.
Historically glutaraldehyde based solutions were the norm but health and
safety concerns have led to the use of safer chemicals based on oxidation.
Arthroscopy is messy.
Collection of fluid run off
will minimise what falls
to the floor. This opaque
plastic film drape has a
100mm x 100mm incise
area and a 200mm x
300mm fluid collection
pouch. Free sample on
request.
Camera systems
Most cameras used for veterinary arthroscopy cannot be autoclaved but
the head and cable can usually be soaked in the same solution as the
arthroscope. Care should be exercised to avoid contact of the sterilizing
fluid with the electrical contacts at the end of the cable. An alternative is
the use of a sterile disposable camera sleeve to separate the camera head
and cable from the sterile arthroscope eyepiece.
Perasafe
Perasafe is a rapid, instrument compatible, user and environmentally
friendly, chemical sterilant. Supplied as a safe, space-saving powder,
Perasafe is activated by simply dissolving in luke-warm tap water. Provides
rapid sterilisation and re-use of endoscopy instruments. Aldehyde-free
formulation gives efficacy without harm to instruments, health risks to
nursing staff and avoids the need for special fume extraction or waste
disposal systems.
INCISE DRAPE WITH FLUID COLLECTION POUCH STERILE
DD198961
Incise Drape with Pouch (Box 40)
£145.00
FCP2527
Fluid Collection Pouch 25cm x 27cm (200 Sterile)
£270.00
Puddle Vac Floor Suction Device
The Puddle Vac can
collect an average of
700ml of fluid per minute.
Simply place where
required. Connect to
standard suction
apparatus.
Perasafe is a pale blue/white powder
which, when in solution, sterilises within
10 minutes. Suitable for all surgical
instruments and fibrescopes. Formulated
not to damage surgical instruments.
Supplied in the following packs.
PUDDLE VAC FLOOR SUCTION DEVICE
PV9321
Puddle Vac (Pack of 5)
£65.00
Super Absorbent Matting
Water, saline, blood or any other
fluid on the theatre floor represent a
significant slip hazard to personnel.
In addition free running fluid is much
more likely to run and penetrate
porous areas creating a longer term
biosecurity hazard.
100100
Perasafe Cold Sterilant 24x81g (5 litres)
£185.00
100101
Perasafe Cold Sterilant 6x81g (5 litres)
£65.00
DE-10-425
Soak basin for chemical solution disinfection,
consisting of basin (perforated) tray
& cover for basin, size: 42x16x9,5cm
DE-5-17
Cleaning brush for small cannulae
with ID:2-4mm, length 17cm
• Three new enzymes
• Easy to use measured bottle
• 2ml per litre dilution
• Removes all organic material
Supplied in 200cm x 40cm mats,
perforated every 25cm for easy
tearing. Also available as a 23 metre
roll.
• Complete rinsibility
• Ideal for endoscopes
• Low foam for ultrasonics
• Biodegradeable
• Tested by The Royal Institute of Public Health
RAPIZYME
Free sample on request
SUPER ABSORBENT MATTING
Super Absorbent Mat 200cm x 40cm
ABMATROLL
Super Absorbent Matting 23 metre roll x 80cm
£22.50
Rapizyme
Super Absorbent Matting is splash
resistant and absorbs 6.5 litres of
water(3.5 litres of saline)per mat.
ABMAT40200
£115.00
£7.25
£175.00
67
Bottle 0.5 Litre
£23.50
2
ARTHROSCOPY & LAPAROSCOPY
Laparoscopes for Minimally
Invasive Surgery
Laparoscopy Start Up Kit
Instrument choice is determined by personal choice and
patient selection. However, a starter kit is a useful starting point
and offers a discounted approach to setting up.
Standard Laparoscopes
The Laparoscopy kit described is discounted by 10% compared to buying
the individual components.
In addition to laparoscopic hand instrumentation a suitable camera, light
source, CO2 insufflator and electrosurgery generator will be required.
Several options, including pre-owned units, are available please telephone
or e-mail to discuss options.
T281-5030
Good optics are a pre-requisite for successful laparoscopy. The more you
see the easier it becomes. Fritz ’scopes have a patented large image
optical system taking in a wide field of vision producing a full screen, very
high definition image.
All the laparoscopes are autoclavable and have standard eyepiece and
light cable connectors.
Code
Description
T281-5030
Wide angle telescope, 0°
OD:5mm, WL: 29cm,
standard light cable connectors,
autoclavable
DE4680-52
Sterilizing & storing tray, 460x80x52mm
perforated stainless steel with silicon bars
230-212V
Cannula only with magnetic valve
ID:10mm, WL:7cm, inflation stopcock, 55g
LAPAROSCOPES - STANDARD
T281-5000
T281-5030
Wide angle telescope, 0˚, OD:5mm, WL:29cm,
standard light cable connectors, autoclavable
£2,550.00
Wide angle telescope, 30˚, OD:5mm, WL:29cm,
standard light cable connectors, autoclavable
£2,550.00
T291-1000
Wide angle telescope, 0˚, OD:10mm, WL:30cm, SIRIUS
system, standard light cable connectors, autoclavable £2,250.00
230-213V
T141-2430
Wide angle telescope, 30˚, OD:2.4mm, WL:14cm,
large image technology
£2,100.00
Cannula only with magnetic valve
ID:10 mm WL:7cm, 45g
230-137V
Safety trocar only
compatible to cannulas with ID:10mm, WL:7cm,
fully dismantable, cork screw handle
231-213V
Cannula only, magnetic valve
ID:5.5mm, WL:7cm, inflation stopcock
231-212V
Cannula only, magnetic valve
ID:5.5mm, WL:7cm, 30g
231-137V
Safety trocar only
compatible to cannulas ID:5,5mm, WL:7cm,
fully dismantable, cork screw handle
230-505
Reducer adapter
for trocar cannulas with ID:10 to 5.5mm
L-19-120
Veress needle, D:2mm, 12cm, LL(f)
531.23H11V
Atraumatic grasper, curved, 5mm
33cm insulated, rotatable, dismantable,
inside ratchet, HF connector
531.02H05V
Mini - Metzenbaum scissors 5mm
33cm insulated, rotatable, dismantable,
531.40H11V
Dissecting forceps, (Maryland)
5mm, 31cm, insulated, dismantable,
silicon handle, inside ratchet
X-300-26
Silicon tube, ID:5mm, 3m, LLm both ends
BP-05-321
Bipolar grasping & cutting forceps
5mm, WL:320mm,
disposable, universal connector
BP2-533-10
Bipolar grasping forceps with std. handle
5mm, WL:34cm, jaws:13 4,5mm with hook
totally dismantable
BP-300-11
Bipolar cable, 3m, comp.to Martin
unit to Martin/Berchtold instrument
S140-2433
Examination Sheath, OD:3.2mm, WL: 12cm,
Compatible with T140-2430 and T141-2430
T181-4030
Wide angle telescope, 30˚, large image technology,
OD:4mm, WL: 18cm, autoclavable
£2,250.00
S180-4033
Examination sheath, OD:5.5mm, WL:17cm, compatible
to T181-4030, stopcock, inc. blunt trochar
£350.00
£285.00
ELECTROCAUTERY & SUCTION
Laparoscopy will require a
bipolar electrocautery
generator to power the
handpieces. The GIMA unit
is very effective and
reasonably priced.
See Chapter 21 Page 314
Adequate suction is also a pre-requisite for
Laparoscopy. Our new Hospivac unit with
2 x 2litre bottle capacity and foot control is
a high capacity suction unit for many
hospital procedures.
See Chapter 21 page 313
ELECTROSURGERY & SUCTION
HF122
GIMA 122 Bipolar Electrosurgery Kit
£975.00
185H350
HospiVac 350 Suction Unit*
£595.00
* Carriage extra
LAPAROSCOPY STARTER KIT
LAPROKIT
68
Laparoscopy Starter Kit
£6,450.00
2
ARTHROSCOPY & LAPAROSCOPY
www.vetinst.com
Palpation, Dissection and
Puncture Instruments
Trochars and Cannulae
Trochar Cannulas with magnetic valving
Laparoscopy First Puncture Needle, Veress
231-213V
LAPAROSCOPY NEEDLE VERESS
Veress Needle 2mm x 100mm Luer Lock
L-19-120
231-137V
£110.00
Thoracoscopy First Puncture Needle, long version
THORACOSCOPY NEEDLE
230-212V
TR-03-201
230-105V
Thoracoscopy Needle 3mm x 200mm
includes sharp trochar
£135.00
Palpation Probe and Puncture Cannula
5mm diameter, 330mm long protected interchangeable needle with outer
tube. Consists of:
Safety trocar tissue pressure exposes the sharp tip
L-33
L-33-2
L-210
Trochar cannulas are designed with different types of valves to reduce or
to avoid CO2 loss when changing instruments and telescope during
laparoscopy and thoracoscopy. Our reusable and patented magnetic valve
trocar system has several advantages compared to other valve types.
They are lightweight and because of the valve construction, the insertion of
instruments and scopes will pass smoothly through without scratching or
touching the front lens like in a so called automatic valve system. In
addition there is nearly no gas loss even when changing instruments.
There are no mechanical parts to clean inside except the magnetic flap
itself which is a great help to your staff.
Inside tube Luer lock Connector
Outside tube/probe
Needle 1 x 26mm
PALPATION PROBE & PUNCTURE CANNULA
L-33-210
Palpation Probe/Cannula
L-210
Injection Cannula 1 x 26mm compatible to L-33/47
£52.00
L-218
Injection Cannula 1.9 x 26mm compatible to L-33/47
£52.00
L-218R
Injection Cannula 2 x 28mm blunt compatible to L-33/47 £52.00
£195.00
Knot Tier and Cutter
5.5MM INNER DIAMETER CANNULAE FOR 5MM ’SCOPES
Cannula only, magnetic valve, ID:5.5mm,
WL:7cm, inflation stopcock
£265.00
231-212V
Cannula only, magnetic valve, ID:5.5mm, WL:7cm, 30g
£295.00
231-204V
Cannula only, magnetic valve, ID:5.5mm, WL:7cm, 30g
£340.00
231-137V
Safety trochar only, comp. to cannulas ID:5.5mm,
WL:7cm, fully dismantable
£340.00
231-105V
Trochar only, with sharp tip
compatible to ID:5.5mm, WL:7cm
£130.00
231-213V
Makes it easy to thread and
tighten sutures. Integrated cutting
device.
5mm diameter 310mm long.
KNOT TIER AND CUTTER
L-19-532
Knot Tier Long Version
Preparation Safety Sponge Forceps
10MM INNER DIAMETER TROCHARS & CANNULAE FOR 10MM ’SCOPES
230-212V
Cannula only, magnetic valve, ID:10mm, WL:7cm,
inflation stopcock, 55g
230-213V
Cannula only, magnetic valve, ID:10mm, WL:7cm, 45g £295.00
230-137V
Safety trochar only, compatible to cannulas with ID:10mm,
WL:7cm, fully dismantable, cork screw handles
£370.00
230-105V
Trochar only with pyramidal tip for trochars cannulas
ID:10mm, WL:7cm
£315.00
5mm diameter, 3 hooks, 330mm. Matt non reflective surface. Strips fully for
cleaning.
£125.00
SAFETY SPONGE FORCEPS
ACCESSORIES
GE-10-553
Safety Sponge Forceps
Reducer adapter for trochar cannulas
with ID:10 to 5.5mm
£33.00
Snap reducer adapter for trochar cannulas
with ID:10 to 5.5mm
£85.00
231-211
Sealing caps, for trochar cannula 5.5mm 10 pcs
£27.00
230-211
Sealing caps for trochars and reducer adapters
£27.00
231-215
Magnetic valve flap 5.5mm, 2 pcs.
£35.00
AUTO GRASPING FORCEPS
230-215
Magnetic valve flap 8/10mm, 2 pcs.
£35.00
L-19-645
230-505
230-525
£225.00
£295.00
Auto Grasping Forceps
5mm diameter, Working length
(WL) 320mm. Easily dismantable.
69
Grasping Forceps
£295.00
2
ARTHROSCOPY & LAPAROSCOPY
5mm Instruments Complete
Hand Instruments
Fritz hand instruments have a modular construction. The handles, the
connecting tubes and the working jaw tips are interchangeable.
Easily stripped down for cleaning, compatible to 5mm and 10mm trochar
cannulas. All handles have a High Frequency connector.
531.40H11V Dissecting Forceps,
5mm, 31cm, insulated, dismantleable, rotatable,
consisting of: jaws insert (53 M 40), sheath
(53 R 1) handle (H 01) colour code: black
Handles
531.23H11V Atraumatic Grasper,
curved 5mm,33cm insulated, rotatable, dismantleable,
inside ratchet, consisting of: jaws insert (53 M 23),
sheath (53 R 1) handle (H11, HF-connector), colour
code: black
HA 11/HN 82
531.22H21V Grasping Forceps,
H 01/H 05/H 11
universal use, 5mm, 33cm, insulated, dismantleable,
rotatable, outside ratchet, consisting of: jaws insert
(53 M 22), sheath (53 R 1) handle (H 21, HFconnector), colour code: black
The handles may have plastic
coated or stainless handles. They
may or may not have a ratchet. The
ratchet may be external or
enclosed. See individual
instruments for exact construction.
531.27H11V Babcock Grasping Forceps,
5 mm, 33 cm, insulated, dismantleable, rotatable,
inside ratchet, consisting of: jaws insert (53 M
27), sheath (53 R 1) handle (H 11, HFconnector), colour code: black
H 21/H 22
Tubular sheaths
531.35H21V DeBakey Grasping
Forceps, 5mm, 33cm, insulated,
dismantleable, rotatable, HF-connector
consisting of: jaws insert (53 M 35) sheath
(53 R 1 handle (H 21, HF-connector) colour
code: black
531.36H21V Bowel Grasping Forceps,
5mm or 10mm diameter options.
Different working lengths which may be rotated through 360 degrees.
Insulated or stainless steel.
5mm, 33cm, insulated, dismantleable, rotatable,
outside ratchet, consisting of: jaws insert (53 M
36), sheath (53 R 1) handle (H 21), colour code:
black
5mm Instruments Complete
536.30H52V Claw Grasping Forceps,
5mm, 33cm, metal, fixed tube, outside ratchet,
consisting of: jaws insert (53 M 36), sheath
(53 R 6) handle (H 52), metal *Only available
with Axial handles (the frog)
Scissors
Mini-Metzenbaum Scissors
531.02H05V
5MM HAND INSTRUMENTS
Hook Scissors 531.04H05V
SCISSORS
531.40H11V
Dissecting Forceps
£425.00
531.23H11V
Atraumatic Grasper
£425.00
531.22H21V
Grasping Forceps
£435.00
531.27H11V
Babcock Grasping Forceps
£435.00
531.35H21V
DeBakey Grasping Forceps
£435.00
531.36H21V
Bowel Grasping Forceps
£435.00
536.30H52V
Claw Grasping Forceps
£435.00
531.02H05V
Mini-Metzenbaum Scissors
£450.00
Hook Scissors
BIPOLAR FORCEPS
531.04H05V
£425.00
BP-05-321
Bipolar grasping & cutting forceps 5mm,
WL:320mm, disposable, universal connector
BP2-533-10
Bipolar grasping forceps with std. handle 5mm, WL:34cm,
jaws:13 4,5mm with hook totally dismantable
£695.00
BP-300-11
Bipolar cable, 3 m, comp.to Martin
unit to Martin/Berchtold instrument
Biopsy Forceps
Biopsy Forceps 531.60H01V
£275.00
£120.00
Laparoscope Instrument Cleaning Kit
Laparoscope instrument cleaning kit consists of:
Biopsy Forceps 531.61H01V
3 x General brush nylon bristles
3 x Laparoscopic Trumpet valve brush
3 x Nylon twisted wire brush 3mm dia
3 x Nylon twisted wire brush 5mm dia
3 x Nylon twisted wire brush 10mm dia
BIOPSY FORCEPS
531.60H01V
Biopsy Forceps
£425.00
LAPAROSCOPE INSTRUMENT CLEANING KIT
531.61H01V
Biopsy Forceps - Double Action Jaw
£425.00
LAPROCLEAN
70
Laparoscope Instrument Cleaning Kit
£145.00